Static and Dynamic Foot Pressure Changes Among Diabetic Patients With and Without Neuropathy: A Comparative Cross-Sectional Study

Introduction: Foot ulceration is a frequent diabetic complication with potentially fatal consequences. The pathophysiology of neuropathic ulcers in the diabetic foot is thought to be influenced by abnormal plantar pressures. Aim: This study aimed to compare the maximum peak pressures among diabetic patients with and without neuropathy. The secondary aim was to evaluate the effect of glycemic control on pressure changes in both feet. Materials and methods: The study used 62 diabetic individuals as participants. BMI was calculated, as well as illness duration, hemoglobin A1c, and the existence of neuropathy. Plantar pressure was measured in static (standing) and dynamic (walking/taking a step on the mat) settings for all patients using the BTS P-Walk system. The plantar pressures (kPa) at the five metatarsal regions, the midfoot region, and the medial and lateral heel regions were measured. Results: We found that the dynamic maximum pressures were significantly higher in patients with diabetic neuropathy (DN) compared to diabetics without neuropathy at the first metatarsal and mid-foot area in both feet (p<0.05). We also found significantly elevated plantar pressure in patients with poor glycemic control under the second metatarsal head in the right foot (p<0.05). Conclusion: Persons with DN have higher maximum plantar pressures compared to diabetics without neuropathy. Patients with poor glycemic control also have a higher maximum pressure.